Abstract
The cases here reported represent a peculiar form of mastoiditis characterized by an infection of long duration, few symptoms and an extensive dry necrosis. Cultures from cases 1, 2 and 4 were negative. In case 3 the laboratory report was: The gram-stained smear shows short streptococci and diphtheroid bacilli; the culture shows gramnegative spored bacilli. It is possible that all of the cases were of<i>Streptococcus mucosus</i>origin as this organism may cause extensive involvement of the bone in the mastoid, with but few symptoms; further, the tympanic involvement may be transient. In case 1 of this report and in certain other cases reviewed, the drum membranes were intact and free from all signs of disease, while in the mastoid a most extensive necrosis was present. Prior to encountering these cases, we were unaware that an extensive necrosis of the mastoid could exist for many years with extremely mild symptoms
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